{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:15:50Z","timestamp":1760058950237,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Patients with heart failure (HF) are at risk of increased morbidity and mortality related to pneumococcal pneumonia, and routine vaccination with a conjugated pneumococcal vaccine (PCV) for HF patients is strongly endorsed by all major international guidelines. Despite this, data on the factors associated with vaccine uptake remain scarce. The aim of this study was to understand the demographic and clinical factors associated with vaccine uptake in patients with HF and analyze the all-cause mortality in the vaccinated and unvaccinated cohorts. Materials and Methods: Four hundred and fifty patients with HF and a reduced ejection fraction followed up at a single center were enrolled. Patients were followed up for a median of 164.0 (148.0\u2013181.0) days. Results: In total, 193 of the 450 patients (42.9%) were vaccinated with PCV-13 at enrollment. Vaccinated patients were more likely to have an implantable device, namely an implantable cardioverter\/defibrillator (ICD), cardiac resynchronization treatment (CRT) or left ventricular assist device (LVAD), and less likely to have a past medical history of hypertension and chronic obstructive pulmonary disease (COPD) at baseline. After multivariable adjustment, the presence of an ICD (OR: 3.17, 95% CI: 1.98\u20135.08), CRT (OR: 2.75, 95% CI: 1.45\u20135.20) and COPD (OR: 0.42, 95% CI: 0.19\u20130.94) remained as determinants of vaccination. All-cause mortality was not different across vaccinated or unvaccinated patients either in the unmatched (log-rank p = 0.67) or matched (log-rank p = 0.52) cohorts. Conclusions: The presence of implantable devices and coexisting COPD was associated with a higher and lower likelihood of vaccination with PCV-13, respectively. No difference in mortality across cohorts was observed in this observational analysis.<\/jats:p>","DOI":"10.3390\/medicina61050869","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T04:13:44Z","timestamp":1746764024000},"page":"869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Demographic and Clinical Determinants of Conjugated Pneumococcal Vaccine Uptake and Short-Term All-Cause Mortality in Vaccinated and Unvaccinated Cohorts in Patients with Heart Failure and Reduced Ejection Fraction: A Prospective Cohort Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7075-2011","authenticated-orcid":false,"given":"Yal\u00e7\u0131n","family":"Velibey","sequence":"first","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4855-573X","authenticated-orcid":false,"given":"Erkan","family":"Kahraman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melih","family":"Oz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5978-5362","authenticated-orcid":false,"given":"Murat","family":"Gokalp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kader","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhsin","family":"Melik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Utku","family":"Ulukoksal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ufuk Egemen","family":"Yazar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Furkan Fatih","family":"Yucedag","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elif","family":"Ozoguz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emre","family":"Ozguclu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mutlu Seyda","family":"Ocalmaz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Microbiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Eren","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman","family":"Bolca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6738-266X","authenticated-orcid":false,"given":"Tolga Sinan","family":"G\u00fcven\u00e7","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istinye University, Istanbul 34396, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"unstructured":"GBD 2017 Disease and Injury Incidence and Prevalence Collaborators (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1789\u20131858.","key":"ref_1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e326","DOI":"10.1016\/S2666-7568(24)00029-1","article-title":"Age-specific mortality trends in heart failure over 25 years: A retrospective Danish nationwide cohort study","volume":"5","author":"Garred","year":"2024","journal-title":"Lancet Healthy Longev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1002\/ejhf.1594","article-title":"Survival of patients with chronic heart failure in the community: A systematic review and meta-analysis","volume":"21","author":"Jones","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1161\/CIRCHEARTFAILURE.107.743146","article-title":"Death in heart failure: A community perspective","volume":"1","author":"Henkel","year":"2008","journal-title":"Circ. Heart Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1161\/CIRCHEARTFAILURE.110.957480","article-title":"A systematic assessment of causes of death after heart failure onset in the community: Impact of age at death, time period, and left ventricular systolic dysfunction","volume":"4","author":"Lee","year":"2011","journal-title":"Circ. Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1093\/eurjpc\/zwae016","article-title":"Association of respiratory infections and the impact of vaccinations on cardiovascular diseases","volume":"31","author":"Rademacher","year":"2024","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.jacc.2007.04.064","article-title":"Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: A report from the OPTIMIZE-HF Registry","volume":"50","author":"Fonarow","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1161\/CIRCRESAHA.122.321636","article-title":"Pneumonia-Induced Inflammation, Resolution and Cardiovascular Disease: Causes, Consequences and Clinical Opportunities","volume":"132","author":"Stotts","year":"2023","journal-title":"Circ. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/MS9.0000000000001486","article-title":"Immunizing hearts: Exploring the vaccination frontier in heart failure management","volume":"86","author":"Shivamadhu","year":"2023","journal-title":"Ann. Med. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.arbres.2022.12.015","article-title":"Pneumococcal Vaccination in Adults: What Can We Learn From Observational Studies That Evaluated PCV-13 and PPV23 Effectiveness in the Same Population?","volume":"59","author":"Dunne","year":"2023","journal-title":"Arch. Bronconeumol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/ehjqcco\/qcaa030","article-title":"Pneumococcal vaccination in adults at very high risk or with established cardiovascular disease: Systematic review and meta-analysis","volume":"7","author":"Antunes","year":"2021","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1093\/ehjci\/ehaa946.1133","article-title":"Impact of influenza and pneumococcal vaccines upon in-hospital mortality in patients with heart failure: A retrospective cohort study in the United States","volume":"41","author":"Gonuguntla","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_14","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"unstructured":"The Strategic Advisory Group of Experts (SAGE) (2024, December 01). Report of the SAGE Working Group on Vaccine Hesitancy [Internet]. Updated. Available online: https:\/\/cdn.who.int\/media\/docs\/default-source\/immunization\/demand\/summary-of-sage-vaccinehesitancy-en.pdf?sfvrsn=abbfd5c8_2.","key":"ref_15"},{"doi-asserted-by":"crossref","unstructured":"Martinelli, M., and Veltri, G.A. (2022). Shared understandings of vaccine hesitancy: How perceived risk and trust in vaccination frame individuals\u2019 vaccine acceptance. PLoS ONE, 17.","key":"ref_16","DOI":"10.1371\/journal.pone.0276519"},{"doi-asserted-by":"crossref","unstructured":"Liu, J., Kassas, B., Lai, J., Kropp, J., and Gao, Z. (2024). Understanding the role of risk preferences and perceptions in vaccination decisions and post-vaccination behaviors among U.S. households. Sci. Rep., 14.","key":"ref_17","DOI":"10.1038\/s41598-024-52408-6"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.jchf.2015.10.012","article-title":"PARADIGM-HF Investigators. Influenza Vaccination in Patients With Chronic Heart Failure: The PARADIGM-HF Trial","volume":"4","author":"Vardeny","year":"2016","journal-title":"JACC Heart Fail."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1161\/CIRCULATIONAHA.118.036788","article-title":"Influenza Vaccine in Heart Failure","volume":"139","author":"Modin","year":"2019","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s10865-023-00393-y","article-title":"Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups","volume":"46","author":"Schwartz","year":"2023","journal-title":"J. Behav. Med."},{"doi-asserted-by":"crossref","unstructured":"Alcendor, D.J., Matthews-Juarez, P., Williams, N., Wilus, D., Tabatabai, M., Hopkins, E., George, K., Leon, A.H., Santiago, R., and Lee, A. (2023). COVID-19 Vaccine Hesitancy and Uptake among Minority Populations in Tennessee. Vaccines, 11.","key":"ref_21","DOI":"10.3390\/vaccines11061073"},{"doi-asserted-by":"crossref","unstructured":"Lamot, M., and Kirbi\u0161, A. (2024). Understanding Vaccine Hesitancy: A Comparison of Sociodemographic and Socioeconomic Predictors with Health Literacy Dimensions. Vaccines, 12.","key":"ref_22","DOI":"10.3390\/vaccines12101141"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1080\/21645515.2017.1392423","article-title":"Health literacy and vaccination: A systematic review","volume":"14","author":"Lorini","year":"2018","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"126437","DOI":"10.1016\/j.vaccine.2024.126437","article-title":"Attitudes and beliefs of healthcare providers toward vaccination in the United States: A cross-sectional online survey","volume":"42","author":"Eiden","year":"2024","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1097\/MLR.0000000000002005","article-title":"Health Care Access and COVID-19 Vaccination in the United States: A Cross-Sectional Analysis","volume":"62","author":"Thomas","year":"2024","journal-title":"Med. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e1835","DOI":"10.1016\/S2214-109X(22)00432-6","article-title":"Influenza Vaccine to Prevent Adverse Vascular Events investigators. Influenza vaccine to reduce adverse vascular events in patients with heart failure: A multinational randomised, double-blind, placebo-controlled trial","volume":"10","author":"Loeb","year":"2022","journal-title":"Lancet Glob. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.ahj.2014.06.024","article-title":"Association between process quality measures for heart failure and mortality among US veterans","volume":"168","author":"Wu","year":"2014","journal-title":"Am. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1056\/NEJMoa1408544","article-title":"Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults","volume":"372","author":"Bonten","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1183\/09031936.00067111","article-title":"Severity and outcomes of hospitalised community-acquired pneumonia in COPD patients","volume":"39","author":"Liapikou","year":"2012","journal-title":"Eur. Respir. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"15948","DOI":"10.1038\/s41598-021-95129-w","article-title":"Comparative effectiveness of pneumococcal vaccination with PPV23 and PCV13 in COPD patients over a 5-year follow-up cohort study","volume":"11","author":"Ignatova","year":"2021","journal-title":"Sci Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"10321","DOI":"10.1073\/pnas.1504019112","article-title":"Countering antivaccination attitudes","volume":"112","author":"Horne","year":"2015","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e835","DOI":"10.1542\/peds.2013-2365","article-title":"Effective messages in vaccine promotion: A randomized trial","volume":"133","author":"Nyhan","year":"2014","journal-title":"Pediatrics"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/869\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:29:53Z","timestamp":1760030993000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,9]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050869"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050869","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2025,5,9]]}}}